A nurse is collecting data from a client who is taking an oral contraceptive. Which of the following findings is a contraindication for the use of oral contraceptives?

A. Headaches with aura: Migraines with aura are a contraindication to combined oral contraceptive use because estrogen-containing contraceptives increase the risk of ischemic stroke in these clients. Alternative non-estrogen methods should be considered to reduce vascular complications. B. Irregular menstrual cycles: Oral contraceptives are often used to regulate menstrual cycles. Irregular cycles alone are not a contraindication and may actually be an indication for therapy. C. History of mononucleosis 1 year ago: A past viral infection such as mononucleosis does not impact the safety of oral contraceptive use. There is no increased risk of thromboembolic events or other complications from a resolved infection. D. Gastroesophageal reflux disease: GERD does not contraindicate oral contraceptive use. While some GI symptoms may be exacerbated in sensitive clients, it is not a medically recognized reason to avoid contraception.